Renal dose dopamine RIP?

Keywords

Dopaminerenal protection

Comments

After decades of debate based on anecdote and a tiny number of trials, a sensible and unsurprising answer has been reached to whether 'renal dose dopamine is of benefit'. No, low dose dopamine does not do any good. Nor indeed is there any evidence from this trial that it does any harm, despite an almost vitriolic denunciation of its use in the accompanying commentary (see Additional information). The trial is exemplary in its design and execution, and, though it frankly discusses its own shortcomings, I can see no justification for the continued use of low-dose dopamine in light of this evidence. What is perhaps surprising and rather depressing is that it has taken this long for such a trial to be undertaken.

Introduction

Low-dose dopamine (< 3 µg/kg/min) has long been advocated as a strategy to effectively manage acute renal impairment. This approach has persisted despite a lack of supporting evidence, and significant, although equally unproven, concerns about its safety. To finally address this longstanding debate a large multicentre, randomised, placebo controlled trial was undertaken.

Methods

All patients admitted to the 23 participating ICUs who presented with or developed acute renal impairment were screened

Patients entered into the trial were randomised to receive either continuous low dose dopamine (at 2 µg/kg/min) or placebo